Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2021
The importance of reconstruction nailing for diaphyseal atypical femoral fractures: a comparative study with standard nailing.
Subtrochanteric atypical femoral fractures (AFFs) usually require long cephalomedullary or reconstruction nailing to achieve satisfactory healing. Recently, this type of nailing has also been recommended to fix diaphyseal AFFs and prevent fragility fractures around the proximal femur, although standard antegrade nailing seems sufficient from a biomechanical perspective. This study aimed to compare treatment outcomes and complications between reconstruction and standard nailing for diaphyseal AFFs. ⋯ In diaphyseal AFFs, reconstruction nailing may achieve a satisfactory outcome and can also decrease delayed peri-implant fragility fractures of the hip, newly developed subtrochanteric AFFs, and nonunion.
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Arch Orthop Trauma Surg · Jul 2021
MRI-only occult geriatric hip fractures: is displacement common with nonoperative treatment?
Although surgical fixation is routinely recommended for geriatric hip fractures, nonoperative treatment may be an option for certain stable fracture patterns. Occult hip fractures are nondisplaced fractures not evident on radiographs, but display intraosseous edema on MRI. Our aim is to report the rate of nonoperative treatment failure in patients with occult geriatric hip fractures. ⋯ Level III.
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Arch Orthop Trauma Surg · Jul 2021
Does trapeziectomy with ligament reconstruction and tendon interposition arthroplasty correct the metacarpophalangeal joint hyperextension associated with trapeziometacarpal osteoarthritis?
Trapeziometacarpal osteoarthritis sometimes results in hyperextension of the thumb metacarpophalangeal (MCP) joint, which could negatively impact outcomes following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. Although algorithms on performing trapeziectomy with LRTI for the management of this deformity are available, they lack clear evidence. Here, we investigate the function of the thumb MCP joint after trapeziectomy with LTRI and whether this procedure alone corrects preoperative MCP hyperextension, and also analyze clinical factors correlated with MCP hyperextension post-surgery. ⋯ Trapeziectomy with LRTI alone could prevent postoperative thumb MCP hyperextension deformity for patients with thumb MCP extension < 30° and improve preoperative thumb MCP hyperextension. However, for patients with loss of radial abduction and MCP flexion due to the contracture, indirect correction of the MCP hyperextension was improbable.
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Arch Orthop Trauma Surg · Jul 2021
Multicenter StudyPreventing ceramic liner fracture after Delta ceramic-on-ceramic total hip arthroplasty.
The results of total hip arthroplasty (THA) with use of Delta ceramic articulation were successful at medium term follow-up. The use of this newest ceramic has markedly reduced the incidence of ceramic head fractures, but not the incidence of ceramic liner fractures. We tested a hypothesis that the ceramic fractures are prevented by use of a metal shell with 18° inner taper angle and a stem design with a reduced neck geometry. ⋯ Therapeutic level II.
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Arch Orthop Trauma Surg · Jul 2021
ReviewManagement of critical-sized bone defects in the treatment of fracture-related infection: a systematic review and pooled analysis.
This systematic review determined the reported treatment strategies, their individual success rates, and other outcome parameters in the management of critical-sized bone defects in fracture-related infection (FRI) patients between 1990 and 2018. ⋯ Results should be interpreted with caution due to the retrospective and observational design of most studies, the lack of clear classification systems, incomplete data reports, potential underreporting of adverse outcomes, and heterogeneity in patient series. A consensus on classification, treatment protocols, and outcome is needed to improve reliability of future studies.